[Thoracoscopic biopsy of pulmonary lesions in nonpulmonary malignancy following chemotherapy].
The appearance of focal pulmonary lesions in a patient with a nonpulmonary malignancy is worrisome. Apart from metastasis, the differential diagnosis includes benign conditions such as infectious and granulomatous diseases, enlarged lymph nodes, atelectasis, radiation pneumonitis, and bronchiolitis obliterans with organizing pneumonia (BOOP). CT-guided needle biopsy is not always diagnostic and may not be feasible in very small lesions. Since open lung biopsy is associated with considerable morbidity, many physicians tend to postpone tissue diagnosis for a few weeks and perform a biopsy only if repeat chest CT scans show increase in size or number of the lesions. This approach may lead to undesirable delay of appropriate treatment. We report video-assisted thoracoscopic lung biopsy in 7 patients with nonpulmonary malignancy who developed lung lesions following chemotherapy and/or radiation therapy. Histological examination proved metastatic lesions in only 2. There were no operative complications and recovery was rapid and smooth in all patients. Thoracoscopic lung biopsy is an effective, minimally invasive diagnostic tool that obviates the need for thoracotomy in these patients.
Zamir
O
O
Surgical Dept., Hadassah-University Hospital, Mount Scopus, Jerusalem.
Ben-Arush
M W
MW
Seror
D
D
Freund
H R
HR
D000293:Adolescent; D000328:Adult; D000970:Antineoplastic Agents / Q000009:adverse effects*; D001707:Biopsy, Needle / Q000379:methods; D002648:Child; D005260:Female; D006801:Humans; D008168:Lung / Q000473:pathology*; D008171:Lung Diseases / Q000139:chemically induced / Q000209:etiology / Q000473:pathology*; D008175:Lung Neoplasms / Q000473:pathology / Q000556:secondary; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy; D011878:Radiotherapy / Q000009:adverse effects; D013906:Thoracoscopy; D014057:Tomography, X-Ray Computed
D000970:Antineoplastic Agents